New model to enhance medical care

In what it describes as a new model for aged care, Victorian provider TLC is developing ‘community healthcare hubs’ at its 10 residential facilities to improve medical care for residents and provide a broader range of services.

The centres will be staffed by GPs, chronic disease nurses, physiotherapists and other allied health professionals. Along with primary care, the centres will house retail pharmacies, telehealth, day respite, radiology and pathology facilities.

The primary healthcare centres will be open to the public, which, combined with new community amenities such as playgrounds and entertainment areas, is intended to stimulate greater community engagement with the residential facilities.

The creation of the community healthcare hubs is part of a $120 million expansion and development program being undertaken by the family-owned provider, which includes new builds and refurbishments at several sites.

TLC’s chief executive officer, Lou Pascuzzi, said that integrating aged care with primary healthcare was the only way providers could meet growing demand from an increasingly frail cohort.

Mr Pascuzzi, a former head of the Medical Centres Division at Healthscope and founder of Peak Health Management, said the current system in aged care of relying on GP visits resulted in inadequate medical supervision and poor continuity of care.

“GPs are domicile to a medical centre, they have a significant patient base to look after. When they’re not compensated to venture out to a residential aged care facility then there’s a significant opportunity cost for them,” Mr Pascuzzi told Australian Ageing Agenda.

Often GPs made appointments to visit residential facilities, but due to the “double booking process at medical centres, the GP is ultimately delayed and never turns up.” Residential facilities were then forced to rely on locum GPs, who were equally problematic, he said.

TLC is building eight community healthcare hubs in total; its two facilities at Wallington will share a combined centre, as will Noble Manor and Noble Gardens, which are similarly close to each other, Mr Pascuzzi said.

Discussing the business model, Mr Pascuzzi said TLC would own the primary care business and, as such, engage GPs on a subcontracted basis.

However, TLC would offer doctors 80 per cent of the fee split on all billings, compared to the current industry average of 60-65 per cent, he said.

“Because this service is primarily geared to service our residents, I’m not looking to make copious amounts of money; single digit EBITDA contributions is all we need,” he said.

Mr Pascuzzi said the 80 per cent rate was “unheard of in the market” and TLC had already received unsolicited approaches from GPs.

TLC’s Homewood facility, where a community healthcare hub will open in March 2015

Additionally, unlike typical medical centres, doctors at the community healthcare hubs would be supported by specialist chronic disease nurses.

The onsite pathology centres will be run by Sonic Healthcare, while the pharmacies will be operated by Quality Pharmacy. “They will operate those services for us and pay rent to us,” he said.

Physiotherapists will be employed directly by TLC, and when not providing care to residents they will provide services to the community out of the hubs, he said. The hubs will also provide dedicated rooms to TLC’s visiting geriatricians on a gratis basis, he added.

The first two centres are due to open at Noble Manor and Forest Lodge in November and December this year, followed by TLC Homewood in Hallam next March.